Midwives have lots of research support encouraging them to be patient with the second stage and wait for physiological expulsion of the baby. Recognizing ways in which we can support the mother to enter that deep trance brain wave state that leads to smooth birth is imperative. I find it very helpful to have new language and concepts for explaining the process to practitioners. Dr. Odent has taught me to wait for the “fetus ejection reflex.” This is a reflex like a sneeze. Once it is there you can’t stop it, but if you don’t have it, you can’t force it. While waiting for the “fetus ejection reflex,” I imagine the mother dilating to “eleven centimeters.” This concept reminds me there may be dilation out of the reach of gloved fingers that we don’t know about, but that some women have to do in order to begin the ejection of the baby. I also find it valuable to view birth as an “elimination process” like other elimination processes-coughing, pooping, peeing, crying and sweating. All are valuable (like giving birth is) for maintaining the health of the body. They all require removing the thinking mind and changing one’s “state.” My friend Leilah is fond of saying, “Birth is a no-brainer.” After all “elimination processes” are finished, we feel a lot better until the next time. Each individual is competent to handle her bodily elimination functions without a lot of input from others. Birth complications, especially in the first-time mother, are often the result of helpful tampering with something that simply needs time and privacy to unfold as intended.

Do not disturb

For anyone who has taken workshops with Dr. Michel Odent, you will have heard him repeat over and over, “Zee most important thing is do not disturb zee birthing woman.” We think we know what this means. The more births I attend, the more I realize how much I disturb the birthing woman. Disturbing often comes disguised in the form of “helping.” Asking the mother questions, constant verbal coaching, side conversations in the room, clicking cameras—there are so many ways to draw the mother from her ancient brain trance (necessary for a smooth expulsion of the baby) into the present-time world (using the neocortex which interferes with smooth birth). This must be avoided. A recent article on the homebirth of model Cindy Crawford describes how the three birth attendants and Cindy’s husband had a discussion about chewing gum while she was giving birth. Cindy describes her experience: “It was absolutely surreal. There I was, in active labor, and they’re debating about gum! I wanted to tell them to shut up, but at that point, I couldn’t even talk.” (Redbook, March 2000). This was in her own home, and she couldn’t control the disturbance that was happening in her first birth. Needless to say, she had a long, painful, exhausting second stage.

Human birth is mammal birth. A cat giving birth to her kittens is a good model to look to for what is the optimal human birth environment: a bowl of water, darkness, a pile of old sweaters, quiet, solitude, privacy and protection from predators. When given this environment, 99.7 percent of cats will give birth to kittens just fine. We spend so much money in North America on labor, delivery and recovery (LDR) rooms and now, adding postpartum, LDRP rooms. Yes, it is an advancement that women are not moved from room to room in the birth process, but there is so much more that can disturb the process: lighting, changing staff, monitoring, beeping alarms, exams, questions, bracelets, tidying, assessing, chattering, touching, checking, charting, changing positions and so on.

When midwives come back from the big maternity hospital in Jamaica, they bring an interesting observation about birth. The birthing women are ignored until they come to the door of the unit and say, “Nurse, I have to go poopy.” They are then brought into the unit and within twenty-five minutes give birth to the baby. Cervical lips are unheard of. Most times, the head is visible when the woman gets onto the birth table. Her entire eight-centimeter-to-head-visible time is done in the company of the other birthing mothers, and she is cautioned not to go near the midwives until the expulsive feeling in her bum is overwhelming. Cesarean section and instrument delivery rates are very low.